羊水过少(oligohydramnios).pptVIP

Posterior urethral valves Good prognostic biochemical markers: Na 100meq/L Cl 90meq/L Osmolarity 210mOsm/L B2 microglobulin 4mg/L Ca 8mg/dl Indication for vesico amniotic shunts * Dr Mona Shroff * * * * * * * * * * * * * * * * Dr Mona Shroff OLIGOHYDRAMNIOS * Dr Mona Shroff PHYSIOLOGY OF AMNIOTIC FLUID * INFLOW (1000 ml/d) 1.FETAL URINE 2.LUNG LIQUID INTRAMEMBRANOUS (placenta,cord) TRANSMEMBRANOUS(amniotic membranes) RECYCLING – 3hrs OUTFLOW (1000 ml/d) 1.FETAL SWALLOWING * Dr Mona Shroff Dr Mona Shroff * Amniotic fluid volume 8 weeks : 15 ml,increases 10 ml/wk 17 wks :250 ml ,increases 50 ml/wk 28-38 wks :750-1000ml (decreases after 34 wks) 42 wks500ml Dr Mona Shroff * FUNCTIONS OF AMNIOTIC FLUID Shock absorber – protects from external trauma. Protects cord from compression. Permits fetal movements – development of musculoskeletal system, prevents adhesions. Swallowing of AF enhances growth development of GIT. AF volume maintains AF pressure – reduces loss of lung liquid – pulmonary development. Maintenance of fetal body temperature. Some fetal nutrition, water supply. Bacteriostatic properties – decreases potential for infection * Dr Mona Shroff DEFINITION AMNIOTIC FLUID VOLUME 5 th percentile for gestational age AMNIOTIC FLUID INDEX 5 SINGLE VERTICAL POCKET 2 cms Amniotic fluid volume of less than 500 mL at 32-36 weeks gestation * Dr Mona Shroff Dr Mona Shroff * INCIDENCE 0.5 – 5% * Dr Mona Shroff AETIOLOGY FETAL PROM (50%) CHROMOSOMAL